| NPI | 1194875641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101051911) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D0047787) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2011-11-01 |